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[20 cases of carcinoid tumors of the digestive system]
J Cantero Hinojosa1, M Gómez Morales, A Maldonado Martín
1Servicios de Medicina Interna y Anatomía Patológica, Hospital Universitario de Granada.
Abstract:
We are presenting 20 cases of carcinoid tumors of the digestive system. We shall evaluate: age, sex, localization and histopathology, symptomatology, therapeutics and evolution. Appendicular carcinoids were the most frequent: 13 cases. All were chance findings in the histopathological examination of surgically resected appendix in eight acute appendicitis and in four laparotomies for other reasons. Histologically the classic pattern predominated, with formation of cellular nidus, with the cells being argentaffin. These characteristics permit classifying them as tumors derived from the embrionary middle intestine. No appendicular carcinoid developed metastasis. The extirpation was always curative, partially due to the small size and to the facility of obstructing the appendicular lumen. Four cases were gastric carcinoids. Their cells grouped forming trabeculas or were arranged irregularly, being negative for argyrophil and argentic tinction (tumors derived from the cephalic intestine). Two of them presented associated peptic ulcer (histamine implication). The two remaining ones came for studies related to asthenia, anorexia and weight loss, and in both cases hepatic metastasis without carcinoid syndrome were found. Two less frequent localizations were Meckel's diverticulum and ampulla of Vater. The latter developed hepatic metastasis without carcinoid syndrome. The only carcinoid syndrome was found in a patient who died due to adult respiratory distress without having localized the primary tumor.